Target-controlled infusion of remimazolam for abdominal surgery:a clinical observation protocol

YANG Xiaoli; LI Jiao; LI Huifen

doi:10.3969/j.issn.2096-2681.2024.05.002

Abstract：Objective To compare the effects of target-controlled infusion(TCI)and constant-rate pump infusion of remimazolam on general anesthesia induction,and to evaluate the performance of three-compartment model and two-compartment model with transit compartment for the metabolite applied to the patient's remimazolam TCI system.Methods A total of 60 patients of either gender,aged 18-65 years,ASA Ⅰ-Ⅲ,undergoing abdominal surgery in the Affiliated Heping Hospital,Changzhi Medical College from March to May 2023 were selected and randomly divided into the control group(n=30)and the experimental group(n=30).Remimazolam was given as a target controlled infusion to the experimental group and as a constant velocity pump injection to the control group with bispectral index(BIS)to track the depth of anesthesia.When the BIS value reached 60,the TCI of remifentanil was maintained at the effect-site concentration of 5 ng/mL,and a single dose of 0.6 mg/kg rocuronium was administrated.The systolic blood pressure(SBP),mean arterial pressure(MAP),heart rate(HR),heart index(CI),BIS value were recorded before anesthesia induction(T0),after loss of consciousness(T1),before intubation(T2),1 min after intubation(T3),3 min after intubation(T4),and 5 min after intubation(T5).Meanwhile,the duration from the beginning of administration to BIS ≤ 60,the use of vasoactive drugs and related adverse reactions during induction were also recorded.Results Compared with the baseline value,SBP,MAP,CI and BIS of both groups showed a slight decrease after administration.However,there was a significant increase in HR(P＜0.05).The time from the start of administration to BIS declining to 60 in the experimental group and control group were(126.6±21.6)s and(354.9±98.8)s,respectively,with a statistically significant difference(P＜0.05).In the experimental group,there were 3 cases of hypotension,3 cases of tachycardia,4 cases of bradycardia,and 2 cases of hiccup.In the control group,there were 1 cases of hypertension,1 cases of hypotension and 1 cases of bradycardia and 4 cases of hiccup.There was no significant difference in adverse reactions between the two groups(P＞0.05).Conclusion Both TCI and constant rate pump infusion of remimazolam can maintain hemodynamic stability of patients during anesthesia induction,and can be safely used in anesthesia induction of general anesthesia.